Resumen

SANTOS, S. et al. Lesões cáusticas do tracto gastrointestinal superior - revisão da literatura e proposta de protocolo de actuação. J Port Gastrenterol. [online]. 2008, vol.15, n.2, pp.63-70. ISSN 0872-8178.

Introduction: Voluntary or accidental caustic ingestion can result in serious injury of the upper gastrointestinal tract. Management of these patients is controversial as far as the best endoscopic and intensive care approach. Objectives: Review of epidemiology, physiopathology, clinical manifestations, evaluation and therapy of caustic lesions and establishment of a protocol. Materials and Methods: A literature review was done, selected from computerized medical data bases (MEDSCAPE, MEDLINE) and Gastroenterology and Intensive Care reference books. Results/Discussion: The clinical features of caustic ingestion vary widely and may not correlate with the severity of injury. Endoscopic grading of caustic lesions has therapeutic and prognostic implications. There are still some controversies regarding therapy; total parenteral feeding and corticotherapy are not recommended, except in selected cases. Conclusions: Caustic ingestion has a significant morbidity and mortality; the best initial approach is still controversial which should be the aim of future additional studies. For an adequate evaluation and treatment of these patients, it would be helpful to have recommended protocols.

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